Individual provider Active NPI

Jacquelyn M Pruitt, NP-C

  • Family Nurse Practitioner
  • Seneca, SC
National Provider Identifier
1780154740
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22107 Issued in SC
Practice address
772 N Townville St
Seneca, SC 29678-2645
Phone
(864) 886-9300
Fax
(864) 886-9399
NPI assigned
Dec 3, 2018
Last updated
Jun 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22107 SC Primary

Addresses

Primary practice location

772 N Townville St
Seneca, SC 29678-2645

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

211 Charda Dr
Westminster, SC 29693-2939
Phone (864) 723-3554

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jpruitt128498@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190218001626 SC Practitioner - Nurse Practitioner 7517205503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

727 SE Main St
Suite 120
Simpsonville, SC 29681-3248
Phone (864) 454-6700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 7, 2019 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 7, 2019 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

2 Office Park Ct
Ste 103
Columbia, SC 29223
Phone (505) 340-5555

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

772 N Townville St
Seneca, SC 29678
Phone (864) 886-9300

727 SE Main St
Ste 120
Simpsonville, SC 29681
Phone (864) 454-6500

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: jpruitt128498@direct.ghs.myhfn.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1780154740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "772 N TOWNVILLE ST",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296782645",
            "telephone_number": "864-886-9300",
            "fax_number": "864-886-9399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Charda Dr",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "SC",
            "postal_code": "296932939",
            "country_code": "US",
            "telephone_number": "864-723-3554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "JACQUELYN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpruitt128498@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jpruitt128498@direct.ghs.myhfn.org",
            "address_1": "772 N Townville St",
            "city": "Seneca",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296782645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.